[Hiring] Authorization Coordinator I @SGA

Role Description

The Authorization Coordinator I processes patient referral requests to support timely and accurate determinations. This role reviews referrals according to standard work, health plan contracts, and utilization management protocols, forwarding requests to nurses or physicians when required.

• Monitors pending referrals
• Maintains turnaround-time standards
• Documents referral updates and determinations
• Assists providers and patients with status questions
• Identifies workflow problems and reports anticipated delays
• Supports process improvements

Success requires organized remote work habits, sound judgment, adaptability, and the ability to manage changing priorities while maintaining accuracy.

Qualifications

• MUST HAVE EPIC EXPERIENCE
• 1+ year experience in healthcare administration, referrals, authorizations, or managed care
• Experience processing referrals according to protocols, health plan requirements, and turnaround times
• Proficiency in medical terminology and healthcare workflows
• Experience with Microsoft Excel, Word, and managed care systems
• Ability to document referral status and determinations accurately
• Ability to identify, understand, and resolve referral-related issues

Requirements

• Experience in a health plan, medical group, or utilization management setting
• Knowledge of CPT, HCPCS, and ICD-9 coding
• Experience obtaining medical information for authorization determinations
• Experience monitoring pending referrals and escalating anticipated delays

Company Description

SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements.

• Diverse team built on core values: customer service, employee development, and quality and integrity
• Commitment to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities